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Cross-Serotype Protection Against Group a Streptococcal Infections Induced by Immunization with Spy 2191

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Cross-Serotype Protection Against Group a Streptococcal Infections Induced by Immunization with Spy 2191 ARTICLE https://doi.org/10.1038/s41467-020-17299-x OPEN Cross-serotype protection against group A Streptococcal infections induced by immunization with SPy_2191 Pooja Sanduja 1,6,8, Manish Gupta 2,8, Vikas Kumar Somani 2,7, Vikas Yadav 1, Meenakshi Dua3, ✉ Emanuel Hanski 4, Abhinay Sharma 4, Rakesh Bhatnagar 5,9 & Atul Kumar Johri 1,9 Streptococcus 1234567890():,; Group A (GAS) infection causes a range of diseases, but vaccine development is hampered by the high number of serotypes. Here, using reverse vaccinology the authors identify SPy_2191 as a cross-protective vaccine candidate. From 18 initially identified surface proteins, only SPy_2191 is conserved, surface-exposed and inhibits both GAS adhesion and invasion. SPy_2191 immunization in mice generates bactericidal antibodies resulting in opsonophagocytic killing of prevalent and invasive GAS serotypes of different geographical regions, including M1 and M49 (India), M3.1 (Israel), M1 (UK) and M1 (USA). Resident splenocytes show higher interferon-γ and tumor necrosis factor-α secretion upon antigen re- stimulation, suggesting activation of cell-mediated immunity. SPy_2191 immunization sig- nificantly reduces streptococcal load in the organs and confers ~76-92% protection upon challenge with invasive GAS serotypes. Further, it significantly suppresses GAS pharyngeal colonization in mice mucosal infection model. Our findings suggest that SPy_2191 can act as a universal vaccine candidate against GAS infections. 1 School of Life Sciences, Jawaharlal Nehru University, New Delhi 110067, India. 2 BSL-3 Unit, Molecular Biology and Genetic Engineering Laboratory, School of Biotechnology, Jawaharlal Nehru University, New Delhi 110067, India. 3 School of Environmental Sciences, Jawaharlal Nehru University, New Delhi 110067, India. 4 Department of Microbiology and Molecular Genetics, The Institute for Medical Research–Israel-Canada(IMRIC), Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel. 5 Banaras Hindu University, Varanasi, Uttar Pradesh, India. 6Present address: Division of Infectious Diseases, Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA. 7Present address: Division of Oncology, Washington University School of Medicine, St. Louis, MO, USA. 8These authors contributed equally: Pooja Sanduja, Manish Gupta. 9These authors jointly supervised this ✉ work: Rakesh Bhatnagar, Atul Kumar Johri. email: [email protected] NATURE COMMUNICATIONS | (2020) 11:3545 | https://doi.org/10.1038/s41467-020-17299-x | www.nature.com/naturecommunications 1 ARTICLE NATURE COMMUNICATIONS | https://doi.org/10.1038/s41467-020-17299-x treptococcus pyogenes or GAS is a human pathogenic promising universal vaccine candidate, in providing significant S bacterium. It causes a range of suppurative diseases protection against the globally prevalent and invasive GAS ser- (pharyngitis, impetigo), invasive diseases [necrotizing fas- otypes in different geographical areas. ciitis, streptococcal toxic shock syndrome (STSS)] and post- streptococcal sequel [Acute rheumatic fever (ARF), rheumatic Results heart disease (RHD), glomerulonephritis]. Annually, GAS causes Inhibition of adherence and invasion. For effective vaccination, 616 million cases of pharyngitis, 18.1 million severe cases and the potential vaccine candidate must be surface exposed, involved 517,000 deaths worldwide1. GAS is ninth leading infectious – in invasion and adherence23 26. Out of 52 previously predicted bacteria in the estimate of mortality and falls with measles, vaccine candidates, 45 sets of immune and preimmune mouse Haemophilus influenza type b and hepatitis B. Further, GAS antisera, generated against recombinant surface/secretory pro- causes high morbidity and mortality mostly in low and middle- teins of GAS (Supplementary Table 1)20,21 were used to investi- income countries. GAS pathogenicity is underestimated due to gate whether the corresponding surface/secretory proteins had lack of data from developing countries (South-Asian and Sub- any role in adherence or invasion. Initially, GAS serotype M49 Saharan African countries). that caused outbreaks in India and USA was used for this study as The M protein of GAS is a surface-exposed protein with a this serotype was found to be most invasive27,28. We found that highly variable N-terminal region that forms the basis of different 18 out of 45 antisera inhibited GAS adhesion by ≥75%; however, serotyping in GAS2. More than 220 serotypes of GAS are pre- only seven antisera abolished invasion by ≥80% (Table 1). We valent in different geographical regions3. Prevalence of a serotype found SPy_2191 antisera inhibited adherence and invasion by 89 also changes in few years with time in different regions4,5. The M and 93%, respectively (Table 1). Preimmunized mice antisera for protein is a major virulence factor of GAS that helps in adhesion each recombinant GAS protein were used as a control. and invasion of bacteria to epithelial cells and also in evading the host innate immune response due to its anti-phagocytic func- tion6–8. Few vaccine preparations like 26-valent, 30-valent and J8 Selection of surface-exposed antigen. One of the criteria for were made based on the M-protein, are currently in phase I or II effective vaccination against any pathogen involves surface clinical trials. Additionally, various other subunit vaccines like exposure of an antigen and its accessibility by specific host- C5a peptidase, GAS carbohydrate and serum opacity factor, have generated antibodies29. To narrow down our focus in subsequent also shown promising results, however no clinical trials were studies on the development of a broad-range GAS vaccine, we conducted related to these preparations9–14. The progress in employed all the 18 antisera (inhibiting adhesion) to confirm the development of an effective vaccine against GAS is further exposure of their respective target antigen on Indian GAS M49 impeded due to serotype diversity in different geographical areas, cell surface using flow cytometry analysis. Data were analyzed antigenic variation within serotype and cross-reacting antibodies using the mean fluorescence intensity (MFI) obtained in both causing auto-immune disorders like ARF and RHD2,3,15,16. immunized and preimmunized antisera. Candidates showing Currently, antibiotics like penicillin and cephalosporins among >2.4-fold increase in MFI as compared to preimmune controls others are in use to combat various GAS diseases. However, were considered significantly surface exposed (Fig. 1a). Out of 18 antibiotic resistance developed by some GAS clinical isolates protein candidates, 10 were found to be significantly exposed on against macrolides and tetracyclines in various geographical GAS cell surface (Fig. 1a, Table 1). regions, has led to a worldwide concern17. Till date, regardless of a high demand globally, no vaccine has been licensed against GAS In silico analysis and selection of SPy_2191. Out of the 10 infections. potential surface-exposed GAS vaccine candidates, nine did not Genome sequences of various pathogenic bacteria and viruses show significant inhibition of invasion and therefore were not are available for the past two decades and have been exploited considered for further experiments (Table 1). Only SPy_2191- immensely in vaccine development. One approach, which was showed significant inhibition of both adhesion and invasion. found to be highly successful to identify universally applicable Additionally, in overlay diagram, GAS M49 incubated with vaccine candidates, is reverse vaccinology. It was first tested on SPy_2191-immunized antisera had significantly higher MFI in serogroup B meningococcus18. Reverse vaccinology coupled with comparison to GAS alone and GAS M49 incubated with pre- comparative genomics, proteomics, and bioinformatics allow immune antisera (Fig. 1b), suggesting SPy_2191 is surface reducing the number of pre-clinical candidates to be analyzed for – exposed. Therefore SPy_2191 was selected for subsequent studies. immunogenicity19 21. It has been established that a successful Our BLAST analysis revealed that the SPy_2191 coding sequence vaccine candidate must be conserved, immunogenic, either sur- was highly conserved across various GAS serotypes of developed face exposed or secretory and should be well expressed22. and developing countries, with >98% similarity in all the GAS Importantly, universal vaccine candidates must protect against genome sequences available in the NCBI database. serotypes prevalent in different geographical areas. Based on reverse vaccinology approach, we predicted a total of 147 genes as universal GAS vaccine candidates. We further validated the in SPy_2191 elicit a humoral immune response. The SPy_2191 fi silico analysis by exploring the distribution pro le of these pre- antigen was expressed in E. coli BL21 (DE3) cells as His6-tagged dicted genes in non-sequenced Indian GAS strains. Among these, recombinant protein and purified to >95% purity by Ni-NTA 52 genes were present in all the prevalent GAS serotypes of affinity chromatography (Supplementary Figs. 1–4). Mice Indian origin21. In the current study, the available 45 recombi- immunization was performed as illustrated in Fig. 2a. The nant sera previously generated against these 52 and the other SPy_2191-specific serum IgG titres were measured at day 14 after reported genes20,21 are screened for their role in adherence and priming, followed by booster immunizations (day 28 and 42) by invasion. Among those that are found to be involved in
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